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Dipper A, Maskell N, Bibby A. Ancillary Diagnostic Investigations in Malignant Pleural Mesothelioma. Cancers (Basel) 2021; 13:cancers13133291. [PMID: 34209209 PMCID: PMC8268996 DOI: 10.3390/cancers13133291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/18/2021] [Indexed: 12/13/2022] Open
Abstract
For a number of patients presenting with an undiagnosed pleural effusion, frailty, medical co-morbidity or personal choice may preclude the use of pleural biopsy, the gold standard investigation for diagnosis of malignant pleural mesothelioma (MPM). In this review article, we outline the most recent evidence on ancillary diagnostic tests which may be used to support a diagnosis of MPM where histological samples cannot be obtained or where results are non-diagnostic. Immunocytochemical markers, molecular techniques, diagnostic biomarkers and imaging techniques are discussed. No adjunctive test has a sensitivity and specificity profile to support use in isolation; however, correlation of pleural fluid cytology with relevant radiology and supplementary biomarkers can enable an MDT-consensus clinico-radiological-cytological diagnosis to be made where further invasive tests are not possible or not appropriate. Diagnostic challenges surrounding non-epithelioid MPM are recognised, and there is a critical need for reliable and non-invasive investigative tools in this population.
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Li N, Mao W, Gao Y, Wang D, Song Z, Chen Z. Liquid chromatography-mass spectrometry based metabolic characterization of pleural effusion in patients with acquired EGFR-TKI resistance. J Pharm Biomed Anal 2021; 202:114147. [PMID: 34029974 DOI: 10.1016/j.jpba.2021.114147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 05/11/2021] [Accepted: 05/16/2021] [Indexed: 02/08/2023]
Abstract
Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) acquired resistance remains a major barrier in the clinical treatment of lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutations. Despite extensive efforts, mechanism of acquired resistance has not yet been elucidated clearly. The subject of this study was to characterize the metabolic signatures relevant to acquired EGFR-TKI resistance in pleural effusion (PE), and identify potential biomarkers in PE of patients with acquired EGFR-TKI resistance. PE from EGFR-TKI untreated group (n = 30) and EGFR-TKI resistant group (n = 18) was analyzed using liquid chromatography-mass spectrometry (LCMS) based metabolomic. Multivariate statistical analysis revealed distinctive diff ;erences between the groups. A total of 34 significantly differential metabolites in PE were identified, among which, the acquired EGFR-TKI resistant group had higher levels of l-lysine, taurine, ornithine and citrulline, and lower levels of l-tryptophan, kynurenine, l-phenylalanine, l-leucine, N-formyl-l-methionine, 3-hydroxyphenylacetic acid and N-acetyl-d-phenylalanine in PE than that of the EGFR-TKI untreated group. These metabolites are mainly involved in six amino acid metabolic pathways. In addition, 3-hydroxyphenylacetic acid and N-acetyl-d-phenylalanine showed the highest AUC values of 0.934 and 0.929 in receiver operating characteristic analysis. Through LCMS metabolomics, our study identified potential biomarkers in PE, differentiating EGFR-TKI resistant patients from untreated patients, as well as the mechanisms underlying acquired EGFR-TKI resistance; thus, providing novel insights into acquired EGFR-TKI resistance.
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Affiliation(s)
- Na Li
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, China; Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, Zhejiang, 310022, China; The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, China
| | - Weimin Mao
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, China; Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, Zhejiang, 310022, China
| | - Yun Gao
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, China; Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, Zhejiang, 310022, China
| | - Ding Wang
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, China; Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, Zhejiang, 310022, China; The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, China
| | - Zhengbo Song
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, China; Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, Zhejiang, 310022, China.
| | - Zhongjian Chen
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, China; Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, Zhejiang, 310022, China.
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Yuan Y, Wu Q, Zhao J, Feng Z, Dong J, An M, Wu G, Qin F, Zhao L. Investigation of pathogenesis and therapeutic targets of acute myeloid leukemia based on untargeted plasma metabolomics and network pharmacology approach. J Pharm Biomed Anal 2020; 195:113824. [PMID: 33358300 DOI: 10.1016/j.jpba.2020.113824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 01/19/2023]
Abstract
Acute myeloid leukemia (AML) is a malignant disease originating from bone marrow hematopoietic stem cells, characterized by anemia, hemorrhage, fever, and infection, with low survival rate. However, the pathogenesis of AML is not fully understood at present. In this work, an integrated approach based untargeted metabolomics and network pharmacology was adopted to elucidate the pathogenesis of AML. Metabolic profiling of plasma samples from 14 patients and 16 healthy individuals were performed based on UHPLC-MS platform. As a result, 23 metabolites were identified by using the human metabolite database based on PLS-DA (partial least squares discriminant analysis) and independent sample test. And metabolic pathways related to AML mainly included fatty acid metabolism, amino acid metabolism, energy metabolism and lipid metabolism. Meanwhile, biomarkers-targets-pathways-disease network was constructed, 75 biomarker targets and 122 disease targets were identified. Furthermore, 30 pathways were predicted, some of which were consistent with these in metabolomics. This is the first time that metabolomics and network pharmacology approach have been combined to investigate the pathogenesis and therapeutic targets of AML. ALDH, CYP2E1 and CYP3A4 were potential therapeutic targets for AML, which provide available way to elucidate the pathogenesis and treatment of AML.
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Affiliation(s)
- Yunxia Yuan
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning Province, PR China
| | - Qiong Wu
- Department of Pediatrics, Shengjing Hospital of China Medical University, PR China
| | - Jing Zhao
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning Province, PR China
| | - Zhiao Feng
- School of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, PR China
| | - Jiani Dong
- School of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, PR China
| | - Ming An
- School of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, PR China
| | - Guodong Wu
- School of Pharmacy, Baotou Medical College, Baotou, Inner Mongolia, PR China
| | - Feng Qin
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning Province, PR China.
| | - Longshan Zhao
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang, Liaoning Province, PR China.
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Zennaro L, Nicolè L, Vanzani P, Cappello F, Fassina A. 1H-NMR spectroscopy metabonomics of reactive, ovarian carcinoma and hepatocellular carcinoma ascites. Pleura Peritoneum 2020; 5:20200113. [PMID: 32566728 PMCID: PMC7292235 DOI: 10.1515/pp-2020-0113] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 04/19/2020] [Indexed: 12/18/2022] Open
Abstract
Background Metabolomic profiling of human malignant effusion remain a field poorly investigated. Proton nuclear magnetic resonance (1H-NMR) spectroscopy is a rapid relatively low cost technique, and effusion is an optimal biospecimen suitable for metabonomic investigations. With this study we addressed metabolomic profiling of malignant ascitic effusion (mAE) from patients with high grade serous ovarian carcinoma (HGSOC), Hepatocellular carcinoma (HCC), and benign AEs (bAEs) from patients with reactive peritonitis. Methods Metabolic profiling with 1H-NMR was performed on 72 AEs (31 HGSOC, 16 HCC and 25 bAE) prospectively collected in our cytology service. Histological confirmation was requested for all malignant case. Multivariate analysis comprising PCA and PLS-DA was applied to discover metabolites suitable to differentiate effusions among the investigated groups. Results 1H-NMR metabonomic analysis showed clearly different spectra for malignant and benign AEs, as well as for HGSOC vs. HCC effusion. When compared with HCC effusions, the HGSOC effusion were enriched, among all, in alanine, lipids, N-acetyl groups and phenylalanine and depleted in glutamine. Conclusions Subject to validation in further larger studies, 1H-NMR metabonomics could be an effective and reliable ancillary tool for AE investigations and diagnosis particularly in acellular effusions.
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Affiliation(s)
- Lucio Zennaro
- Department of Molecular Medicine, University of Padova School of Medicine and Surgery, Padova, Italy
| | - Lorenzo Nicolè
- Department of Medicine, University of Padova School of Medicine and Surgery, Padova, Italy
| | - Paola Vanzani
- Department of Molecular Medicine, University of Padova School of Medicine and Surgery, Padova, Italy
| | - Filippo Cappello
- Department of Medicine, University of Padova School of Medicine and Surgery, Padova, Italy
| | - Ambrogio Fassina
- Department of Medicine, University of Padova School of Medicine and Surgery, Padova, Italy
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Davidson B. Molecular testing on serous effusions. Diagn Cytopathol 2020; 49:640-646. [PMID: 32023012 DOI: 10.1002/dc.24392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 01/23/2020] [Indexed: 12/16/2022]
Abstract
Serous effusions constitute a significant part of the material processed and diagnosed by cytopathology laboratories. Effusions may occur in a variety of clinical settings and the differential diagnosis between these conditions often requires ancillary tests. Immunohistochemistry is still the most frequently used method in this context. However, a wide array of other methods measuring the expression of DNA, mRNA, noncoding RNA, proteins, and other compounds may be applied to the diagnosis of serous effusions, particularly in the setting of cancer, as well as to studies focusing on tumor biology and understanding of tumor progression. In addition, as serous effusions provide ideal material for molecular testing, they have in recent years assumed central role as specimens informative of prediction in the context of targeted therapy, as well as prognostication. This review discusses recent studies in this field.
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Affiliation(s)
- Ben Davidson
- Department of Pathology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,The Medical Faculty, University of Oslo, Oslo, Norway
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Yang Z, Song Z, Chen Z, Guo Z, Jin H, Ding C, Hong Y, Cai Z. Metabolic and lipidomic characterization of malignant pleural effusion in human lung cancer. J Pharm Biomed Anal 2019; 180:113069. [PMID: 31884394 DOI: 10.1016/j.jpba.2019.113069] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/27/2019] [Accepted: 12/21/2019] [Indexed: 12/31/2022]
Abstract
Malignant pleural effusion (MPE) is an important hallmark for late-stage lung cancer with metastasis. Current clinical diagnosis methods require tedious work to distinguish MPE from benign pleural effusion (BPE). The objective of this study was to characterize the metabolic signatures in MPE of lung cancer, and identify potential metabolite biomarkers for diagnosis of MPE. MPE from lung cancer (n = 46) and BPE from tuberculosis patients (n = 32) were investigated by liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based global metabolomic and lipidomic profiling. Multivariate partial least-square discriminative analysis models exhibited distinct metabolic profiles between MPE and BPE. A total of 25 ether lipids, including phosphatidylcholines (PC), lysophosphatidylcholines (LPC) and phosphatidylethanolamines (PE), were observed to be significantly downregulated in MPE with excellent diagnostic potential. Plasmalogen PC(40:3p) showed highest AUC value of 0.953 in receiver operating characteristic (ROC) model. Oxidized polyunsaturated fatty acids (PUFA) were upregulated in MPE. The obtained results implied a high oxidative stress and peroxisome disorder in lung cancer patients. Combined metabolomic and lipidomic profiling have discovered potential biomarkers in MPE with excellent clinical diagnostic capability. Dysregulated ether lipids and oxidized PUFAs have implied an aberrant redox metabolism, which provides novel insights into the pathology of MPE in lung cancer.
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Affiliation(s)
- Zhiyi Yang
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Zhengbo Song
- Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Zhongjian Chen
- Department of Cancer Research, Zhejiang Cancer Hospital, Hangzhou, China
| | - Zhenyu Guo
- HKBU Institute for Research and Continuing Education, Shenzhen, China
| | - Hangbiao Jin
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Cheng Ding
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Yanjun Hong
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China; HKBU Institute for Research and Continuing Education, Shenzhen, China.
| | - Zongwei Cai
- State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China.
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Nicolè L, Cappello F, Cappellesso R, VandenBussche CJ, Fassina A. MicroRNA profiling in serous cavity specimens: Diagnostic challenges and new opportunities. Cancer Cytopathol 2019; 127:493-500. [DOI: 10.1002/cncy.22143] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Lorenzo Nicolè
- Surgical Pathology and Cytopathology Unit, Department of Medicine University of Padua Padua Italy
| | | | - Rocco Cappellesso
- Surgical Pathology and Cytopathology Unit, Department of Medicine University of Padua Padua Italy
| | - Christopher J. VandenBussche
- Department of Pathology Johns Hopkins University School of Medicine Baltimore Maryland
- Department of Oncology Johns Hopkins University School of Medicine Baltimore Maryland
| | - Ambrogio Fassina
- Surgical Pathology and Cytopathology Unit, Department of Medicine University of Padua Padua Italy
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Engels M, Michael C, Dobra K, Hjerpe A, Fassina A, Firat P. Management of cytological material, pre-analytical procedures and bio-banking in effusion cytopathology. Cytopathology 2019; 30:31-38. [PMID: 30430668 DOI: 10.1111/cyt.12654] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 10/27/2018] [Accepted: 10/31/2018] [Indexed: 12/18/2022]
Abstract
Serous effusion fluid is one of the most commonly encountered specimens in routine cytopathology practice. It provides invaluable information about the patient and the clinical status; but to get the most of it, specimen handling and processing must be carried out properly. Cytomorphology is the basis of a successful analysis which should complemented by ancillary tests when needed. A wide spectrum of ancillary techniques - ranging from immunocytochemistry and flow cytometry to different assays of molecular pathology - can be applied to serous effusions. This article describes the acquisition and management of serous effusion fluids, methods for preservation and transportation, different techniques of cytopreparation, application of immunocytochemistry, flow cytometry, and fluorescence in-situ hybridization (FISH), as well as DNA extraction for polymerase chain reaction (PCR) and next generation sequencing (NGS). Principles of bio-banking of effusion samples are also discussed which is getting more important in correlation with the developments in personalized medicine.
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Affiliation(s)
- Marianne Engels
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - Claire Michael
- Department of Pathology, Case Western Reserve University/University Hospitals Cleveland Health Center, Cleveland, Ohio
| | - Katalin Dobra
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anders Hjerpe
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ambrogio Fassina
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padova, Padova, Italy
| | - Pinar Firat
- Department of Pathology, Koc University School of Medicine, Istanbul, Turkey
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Yang W, Zhou G, Zou S, Yang W, Liu A, Sun S, Xie B. Metabonomics of d-glucaro-1,4-lactone in preventing diethylnitrosamine-induced liver cancer in rats. PHARMACEUTICAL BIOLOGY 2018; 56:643-648. [PMID: 31070541 PMCID: PMC6292356 DOI: 10.1080/13880209.2018.1525414] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
CONTEXT d-Glucaro-1,4-lactone (1,4-GL) exists in many vegetables and fruits. Metabonomics has not been used to investigate the role of 1,4-GL in preventing liver cancer. OBJECTIVE The pharmacological effects and metabolite alterations of 1,4-GL on the prevention of diethylnitrosamine (DEN)-induced liver cancer were investigated. MATERIALS AND METHODS Ten healthy Sprague-Dawley rats served as control and 46 were used to establish rat liver cancer model. 1HNMR-based metabonomics was used to compare the effects of oral 1,4-GL (50 mg/kg) in liver cancer rats (n = 26) after 10 consecutive weeks of intervention. The amino acids in rat serum were quantified by HPLC-UV, and the changes in Fischer's ratio were calculated. RESULTS The 20-week survival rate of DEN-induced liver cancer rats administered with oral 1,4-GL was increased from 45.0 to 70.0% with reduced carcinogenesis of the liver and significantly lowered serum α-fetoprotein level (14.28 ± 2.89 ng/mL vs. 18.56 ± 4.65 ng/mL, p = 0.012). The serum levels of leucine, valine, 3-hydroxybutyrate, lactate, acetate and glutamine in the DEN + 1,4-GL group returned to normal levels compared with those of the DEN group on week 20. Fischer's ratio in the rat serum of DEN group was 1.62 ± 0.21, which was significantly lower than that in healthy rats (2.3 ± 0.12). However, Fischer's ratio increased to 1.89 ± 0.22 in the DEN + 1,4-GL group. DISCUSSION AND CONCLUSIONS 1,4-GL exerted positive effects on liver carcinogenesis in rats by pathological examination and metabonomic analysis. Its mechanism may be related to the restoration of amino acid and energy metabolism.
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Affiliation(s)
- Wenlong Yang
- Department of Infectious Diseases, the Second Affiliated Hospital of Nanchang University; School of Pharmaceutical Science, Nanchang University, Nanchang, PR China
| | - Guanlin Zhou
- Department of Infectious Diseases, the Second Affiliated Hospital of Nanchang University; School of Pharmaceutical Science, Nanchang University, Nanchang, PR China
| | - Shubing Zou
- Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Wentao Yang
- Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Aihong Liu
- Center of analysis and testing, Nanchang University, Nanchang, PR China
| | - Shuilin Sun
- Department of Infectious Diseases, the Second Affiliated Hospital of Nanchang University; School of Pharmaceutical Science, Nanchang University, Nanchang, PR China
| | - Baogang Xie
- Department of Infectious Diseases, the Second Affiliated Hospital of Nanchang University; School of Pharmaceutical Science, Nanchang University, Nanchang, PR China
- CONTACT Baogang Xie Department of Infectious Diseases, the Second Affiliated Hospital of Nanchang University; School of Pharmaceutical Science, Nanchang University, 330006, PR China
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Influence of Metabolite Extraction Methods on 1H-NMR-Based Metabolomic Profiling of Enteropathogenic Yersinia. Methods Protoc 2018. [PMCID: PMC6481057 DOI: 10.3390/mps1040045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Metabolite extraction is one of the critical steps in microbial metabolome analysis. It affects both the observed metabolite content and biological interpretation of the data. Several methods exist for metabolite extraction of microbes, but the literature is not consistent regarding the sample model, adequacy, and performance of each method. In this study, an optimal extraction protocol for Yersinia intracellular metabolites was investigated. The effect of five extraction protocols consisting of different extraction solvent systems (60% methanol, 100% methanol, acetonitrile/methanol/water (2:2:1), chloroform/methanol/water (2:1:1), and 60% ethanol) on Yersinia metabolic profiles were compared. The number of detected peaks, sample-to-sample variation, and metabolite yield were used as criteria. Extracted metabolites were analyzed by 1H-NMR and principal component analysis (PCA), as well as partial least squares discriminant analysis (PLS-DA) multivariate statistics. The extraction protocol using 100% methanol as the extraction solvent provided the highest number of detected peaks for both Yersinia species analyzed, yielding more spectral information. Together with the reproducibility and spectrum quality, 100% methanol extraction was suitable for intracellular metabolite extraction from both species. However, depending on the metabolites of interest, other solvents might be more suitable for future studies, as distinct profiles were observed amongst the extraction methods.
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Nicolè L, Cappellesso R, Sanavia T, Guzzardo V, Fassina A. MiR-21 over-expression and Programmed Cell Death 4 down-regulation features malignant pleural mesothelioma. Oncotarget 2018; 9:17300-17308. [PMID: 29707109 PMCID: PMC5915117 DOI: 10.18632/oncotarget.24644] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 02/27/2018] [Indexed: 12/26/2022] Open
Abstract
Background Differential diagnosis between malignant pleural mesothelioma (MPM) and benign mesothelial conditions is still challenging and there is a lack of useful markers. Programmed cell death 4 (PDCD4) is a well-known tumor suppressor gene in several cancers, its post-transcriptional activity is directly controlled by miR-21, whose over-expression has been recently reported in MPM compared to normal mesothelium. Aim of this study was to test this suppressor gene as a possible new marker of malignant transformation in mesothelial cells, as well as a new prognostic marker. Methods PDCD4 nuclear expression was assessed by immunohistochemistry (IHC) in 40 non-neoplastic pleural (NNP) and 40 MPM formalin-fixed and paraffin-embedded specimens. PDCD4 and miR-21 expressions were analyzed by qRT-PCR in all cases. In situ hybridization (ISH) of miR-21 was performed in 5 representative cases of both groups. The prognostic relevance of PDCD4 was assessed in a public available gene expression dataset. Results IHC showed that PDCD4 nuclear expression was significantly lower in MPM than in NNP. PDCD4 was down-regulated, whereas miR-21 was over-expressed in MPM cases compared to NNP ones. ISH detected miR-21 only in MPM specimens. Down-expression of PDCD4 was found significantly associated with short overall survival in publicly available data. Conclusions These findings highlighted a switch between PDCD4 and miR-21 expression in MPM. Further studies should assess the diagnostic reliability of these two markers for MPM in biopsy and effusion specimens.
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Affiliation(s)
- Lorenzo Nicolè
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padova, Padova, Italy
| | - Rocco Cappellesso
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padova, Padova, Italy
| | - Tiziana Sanavia
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Vincenza Guzzardo
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padova, Padova, Italy
| | - Ambrogio Fassina
- Department of Medicine, Surgical Pathology & Cytopathology Unit, University of Padova, Padova, Italy
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Porcel JM. Biomarkers in the diagnosis of pleural diseases: a 2018 update. Ther Adv Respir Dis 2018; 12:1753466618808660. [PMID: 30354850 PMCID: PMC6204620 DOI: 10.1177/1753466618808660] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 10/03/2018] [Indexed: 12/18/2022] Open
Abstract
The use of biomarkers on pleural fluid (PF) specimens may assist the decision-making process and enhance clinical diagnostic pathways. Three paradigmatic examples are heart failure, tuberculosis and, particularly, malignancy. An elevated PF concentration of the amino-terminal fragment of probrain natriuretic peptide (>1500 pg/ml) is a hallmark of acute decompensated heart failure. Adenosine deaminase, interferon-γ and interleukin-27 are three valuable biomarkers for diagnosing tuberculous pleurisy, yet only the first has been firmly established in clinical practice. Diagnostic PF biomarkers for malignancy can be classified as soluble-protein based, immunocytochemical and nucleic-acid based. Soluble markers (e.g. carcinoembryonic antigen (CEA), carbohydrate antigen 15-3, mesothelin) are only indicative of cancer, but not confirmatory. Immunocytochemical studies on PF cell blocks allow: (a) to distinguish mesothelioma from reactive mesothelial proliferations (e.g. loss of BAP1 nuclear expression, complemented by the demonstration of p16 deletion using fluorescence in situ hybridization, indicate mesothelioma); (b) to separate mesothelioma from adenocarcinoma (e.g. calretinin, CK 5/6, WT-1 and D2-40 are markers of mesothelioma, whereas CEA, EPCAM, TTF-1, napsin A, and claudin 4 are markers of carcinoma); and (c) to reveal tumor origin in pleural metastases of an unknown primary site (e.g. TTF-1 and napsin A for lung adenocarcinoma, p40 for squamous lung cancer, GATA3 and mammaglobin for breast cancer, or synaptophysin and chromogranin A for neuroendocrine tumors). Finally, PF may provide an adequate sample for analysis of molecular markers to guide patients with non-small cell lung cancer to appropriate targeted therapies. Molecular testing must include, at least, mutations of epidermal growth-factor receptor and BRAF V600E, translocations of rat osteosarcoma and anaplastic lymphoma kinase, and expression of programmed death ligand 1.
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Affiliation(s)
- José M. Porcel
- Pleural Medicine Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, Avda Alcalde Rovira Roure 80, 25198 Lleida, Spain
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